Worried about the high costs of health care? Fearful that insurers again won't cover you if you have a pre-existing condition?

So many Americans feel that way that health care has emerged as the No. 1 topic on voters' minds this fall and could carry the Democrats into a House majority, a reversal over 2010 when outrage over the Affordable Care Act led to a Republican takeover of the chamber.

Almost six of every 10 campaign ads after Labor Day in support of House Democratic candidates mention health care, according to the Wesleyan Media Project, which tracks political advertising.

"Worries about rising health care costs top the list of voter concerns, which is true not just in New Jersey but nationwide," said Patrick Murray, director of the Monmouth University Polling Institute, whose poll earlier this month named health care as the top issue among New Jersey likely voters.

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President Donald Trump speaks as House Republicans came to the White House to celebrate repealing the Affordable Care Act on May 4, 2017. (Stephen Crowley | The New York Times)

Voter backlash to the unsuccessful efforts by President Donald Trump and congressional Republicans to repeal the law, which would have left as many as 32 million more Americans uninsured, has put several Republican incumbents in jeopardy, including both Reps. Tom MacArthur, R-3rd Dist., and Leonard Lance, R-7th Dist.

The issue is also a strength for Democratic U.S. Sen. Robert Menendez, who helped draft the original Obamacare bill, in his tough fight with Republican Bob Hugin, a former pharmaceutical executive.

The Democrats' ads have dubbed the Republican repeal efforts "Trumpcare," seeking to take advantage of both the president's unpopularity and the current support for the ACA, which was backed by 54 percent of likely voters in a Fox News poll, with 43 in opposition.

Meanwhile, false claims about Republican and Democratic positions on health care have become a staple of the president's speeches at his political rallies.

Here's what you need to know about the top issue in the 2018 campaign.

And it provides $1 billion in federal funds to the state annually to cover most of the costs of expanding Medicaid.

As a result, 472,226 additional New Jerseyans now have health insurance, 688,068 in 2017 versus 1.2 million in 2013, according to New Jersey Policy Perspective, a progressive research group. That lowered the uninsured rate to 7.7 percent in 2017 compared with 13.2 percent in 2013.

Around 800,000 New Jerseyans are receiving coverage under the health care law, 500,000 through Medicaid and about 300,000 through private insurance.

Those buying insurance through the Affordable Care Act can expect an average reduction in their premiums of 9.3 percent next year as Gov. Phil Murphy and the Democratic-controlled legislature enacted two laws to address the problems caused by congressional Republican repeal efforts.

The legislation required all state residents to carry insurance or pay a penalty, and set up a reinsurance program to protect insurers from very high medical claims.

New Jersey insurers last year sought double-digit rate hikes, partly in response to Trump and GOP proposals to repeal the health care law or weaken its provisions administratively.

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Where Menendez stands

As a member of the Senate Finance Committee, which has jurisdiction over health care issues, U.S. Sen. Robert Menendez, D-N.J., helped draft the original Affordable Care Act and fought Republican repeal efforts, which failed by one vote in his chamber.

He also voted against the Republican tax bill that ended the requirement that all Americans carry health insurance or pay a penalty.

Menendez has gone after his Republican challenger, Bob Hugin, former chief executive of Celgene Corp., which lobbied against legislation making it easier for generic companies to bring lower-cost alternatives to market, and which raised the price of its Revlimid cancer drug 20 percent last year in the U.S while cutting it in Russia.

In June, Menendez added his name as a co-sponsor to the generic drug bill Celgene under Hugin lobbied against.

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Where Hugin stands

Hugin also has cited his experience leading Summit-based Celgene as he offered his own proposals to fix the health care system.

He said he would keep what he deemed the "good" things about current health care law, including guaranteeing affordable coverage for pre-existing conditions and allowing people to stay on their parents' insurance until 26 years old. To help lower-income Americans, he would cap drug co-pays at $50 and limit monthly out-of-pocket expenses.

Hugin also called for changing the way care was delivered, taking advantage of information technology to overhaul the entire health system, including acting to keep patients healthy rather than treat them after they became ill.

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MacArthur voted yes. Constituents may vote him out.

The House Republican repeal effort appeared to be dead before New Jersey's Rep. Tom MacArthur offered an amendment giving the states more freedom to waive the law's requirements that all insurance policies offer certain benefits. The most conservative House Republicans agreed and the repeal bill narrowly passed.

MacArthur, R-3rd Dist., has insisted otherwise, and even claimed in his campaign literature to have fought for such protections. But his role in helping House Republicans repeal the law remains unpopular and is one reason his re-election race is so tight.

His Democratic challenger, former national security aide Andy Kim, has gone after MacArthur on health care and has the money to keep doing so. Through Oct. 17, he outraised the incumbent, $5.2 million to $3.1 million, forcing MacArthur to pump $1.4 million of his own money into the campaign.

The Cook Political Report, a Washington-based publication that tracks congressional races, called the race a tossup.

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Lance's earlier votes may come back to haunt him

When the House Republican repeal bill reached the floor last year, Rep. Leonard Lance, R-7th Dist., voted no. He then joined a bipartisan group of lawmakers in proposing changes to the law, which House Republican leaders refused to bring up for a vote.

But before Republicans controlled both houses of Congress and the White House, Lance joined with his colleagues and supported efforts to repeal the legislation.

That's what his Democratic challenger, former Assistant U.S. Secretary of State Tom Malinowski, has been hammering on. Like Kim, Malinowski has the resources to keep making that argument, having raised $5.3 million through Oct. 17, more than double the $2.3 million Lance has brought in.

Like MacArthur, Lance was given no better than a 50-50 chance to retain his seat by the Cook Political Report.

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President Donald Trump talks to House Speaker Paul Ryan R-Wis., in the Rose Garden of the White House in May 2017 in Washington, after House Republicans voted to repeal the Affordable Care Act. (AP Photo | Evan Vucci)

Trump inserts himself into the debate

The president, who promised during the campaign to provide health care for everyone and not to cut Medicaid, broke both pledges when he endorsed the Republican repeal efforts.

Having failed to get rid of the ACA, he since has taken several steps administratively to weaken the law and its requirement that insurers provide comprehensive coverage.

His tax bill ended the individual mandate for people to buy insurance, and his administration has argued that the provisions insurers from charging more, or refusing to cover, those with pre-existing conditions were unconstitutional.

He moved to expand the use of temporary short-term insurance policies, which do not cover pre-existing conditions and offer limited coverage, making their premiums so cheap; has reduced the enrollment period; and cut funding for navigators that help people sign up.

In the Fox News poll, 57 percent of likely voters disapproved of the way Trump was handling health care, compared with 37 percent who approved.

The president also has taken to falsely claiming that he and the Republicans support covering people with pre-existing conditions, after spending months working to take such protection away.

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Knowing how unpopular the Republicans' position is Trump has made a staple of his campaign speeches the false claim that he is the one fighting to protect pre-existing conditions while the Democrats want to hurt those with diabetes or cancer.

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Republicans will totally protect people with Pre-Existing Conditions, Democrats will not! Vote Republican.

* MacArthur's attempts to help Trump on the Obamacare repeal are hurting him, as 32 percent of 3rd District voters say they're less likely to vote for him because of it, as compared to 16 percent who say they are more likely to vote for him, according to a Stockton University poll

* More than three-quarters of voters say covering pre-existing conditions should remain law. It's a consistent number: 76 percent in the Stockton poll of the 3rd Congressional District, and 75 percent of all Americans, according to the Kaiser Family Foundation.